Concerns on Part D Persist

Article excerpt

"The numbers are showing this is working," stated Mark McClellan, administrator of the federal Centers for Medicare and Medicaid Services (CMS). With Medicare's Part D prescription drug benefit, he said, "People are getting the kind of coverage they want and it's costing much less, much less than people expected. That's because of the competition." McClellan was speaking to reporters following his address at the 2006 Joint Conference of National Council on Aging (NCOA) and American Society on Aging (ASA) in Anaheim, Calif., in March.

McClellan said that most of Medicare's 42 million beneficiaries, who either are elders or have disabilities, would be enrolled in Part D by the May 15 signup deadline. At Aging Today press time, CMS had announced that more than 30 million people were covered for prescription drugs about three weeks before the deadline, with about 7 million eligible for the program remaining unenrolled. The Kaiser Family Foundation, though, reported ( 7453-cfm) that Part D enrollment falls short of CMS's 2005 projection that 39 million would be covered (29.3 million, plus about io million in other plans). As of mid-March, only 17.9 million were enrolled in Part D and 9.7 million had other coverage, with 11.4 million still needed to reach the CMS target enrollment figure.


Even critics of Part D's design agree that many people are not enrolling who would benefit. "For most people who are not also Medicaid beneficiaries or are not in special circumstances, this is a good deal," said Marilyn Moon, vice president and director of the American Institute for Research, Silver Spring, Md. Moon, a former public trustee of Medicare, spoke as a respondent to McClellan at the closing conference session.

Another respondent, Howard Bedlin, NCOA vice president of public policy and advocacy, emphasized that his association supported the Part D legislation initially to "lock in the money because it was a short-term opportunity to actually get this thing funded-lock in the money and then let's make the improvements down the road."

At the Joint Conference, Moon and Bedlin raised troubling questions about such aspects of the program as required copayments for even the poorest elders, the asset test that bars many elders from qualifying for the low-income subsidy, and the continuing confusion older people face in choosing a plan.

In his address, McClellan said that Part D-which provides enrollees about $1,100 toward purchasing one of many special insurance policies covering prescription drugs-is integral to "a fundamental and lasting change." He explained, "It's one that's absolutely essential as we move Medicare from a program that happens to be there to help you pay the bills when you get sick to a program that's going to be your partner, your personal partner, in enabling you to take advantage of all that modern medicine has to offer to stay well, take charge of your health, prevent complications and live a longer and better life."

McClellan credited a broad range of groups, such as ASA and the NCOAorganized Access to Benefits Coalition, for working with CMS to build a national grassroots network of more than 10,000 partner organizations to help sign up millions of Medicare beneficiaries. Grassroots outreach, he said, would particularly continue targeting low-income people-the hardest beneficiaries to reach. These people receive too much income to be eligible for Medicaid assistance, but may still qualify for the low-income subsidy (LIS) under the new law.

Because only about 1.6 million of the estimated 8.2 million people in this category were approved for LIS coverage under Part D by the May 15 deadline, McClellan said the program would allow those needing extra help to sign up beyond that date. In April, CMS announced that it would permit ongoing enrollment for these beneficiaries, even though other Medicare beneficiaries who missed the deadline, cannot join again until the next open-enrollment period begins in November. …